Microplate Fixation without Maxillomandibular Fixation in Double Mandibular Fractures

Abstract

BackgroundMaxillomandibular fixation (MMF) is usually used to treat double mandibular fractures. However, advancements in reduction and fixation techniques may allow recovery of the premorbid dental arch and occlusion without the use of MMF. We investigated whether anatomical reduction and microplate fixation without MMF could provide secure immobilization and correct occlusion in double mandibular fractures.MethodsThirty-four patients with double mandibular fractures were treated with open reduction and internal fixation without MMF. Both fracture sites were surgically treated. For bony fixations, we used microplates with or without wire. After reduction, each fracture site was fixed at two or three points to maintain anatomical alignment of the mandible. Interdental wiring was used to reduce the fracture at the superior border and to enhance stability for 6 weeks. Mouth opening was permitted immediately.ResultsNo major complications were observed, including infection, plate exposure, non-union, or significant malocclusion. Five patients experienced minor complications, among whom the only one patient experienced a persistant but mild malocclusion with no need for additional management.ConclusionThis study showed that double mandibular fractures correction with two- or three-point fixation without MMF simplified the surgical procedure, increased patient comfort, and reduced complications, due to good stability and excellent adaptation.

Role of 1.5 mm microplates in treatment of symphyseal fracture of mandible: A stress analysis based comparative study

“…There are few studies that have shown the efficacy of microplate in similar fracture condition where miniplates are currently being used. [3][4][5] [ 3 _ T D $ D I F F ] The use of microplate may be considered as meaningful shift from current practice as it is less traumatic to soft tissues, cause less priosteal tissue reflection and also make use of less implant material. Thus, it is necessary to study the efficacy of such fixture plates for mandibular fractures which has less implant material (foreign body), provides optimum rigidity, and is strong enough to bear the masticatory load with un-compromised bone healing.…”

Manual versus rigid intraoperative maxillo‐mandibular fixation in the surgical management of mandibular fractures: A European prospective analysis

“…8,[13][14][15][16] There is no consensus regarding the indications for manual MMF because most of the previous studies have focused on certain fracture patterns or have included fractures that were treated conservatively. 7,12,[15][16][17] The present study only included mandibular fractures treated with ORIF, and excluded those managed conservatively. In these latter cases, both intra-and postoperative MMF were necessary for bone healing.…”

“…7,8,11,12 An increasing number of studies have reported the use of manual intraoperative MMF, without the need for wire-based techniques, for certain mandibular fractures since the 1990s. 6,7,9,[11][12][13][14][15][16][17][18] However, a recent systematic review and meta-analysis by Singh et al 8 on isolated single or double mandibular fractures suggested that the current evidence in favour of manual MMF is based on a few retrospective and prospective, single-centre studies, with a high risk of bias.…”

Absorbable Plate-Related Infection after Facial Bone Fracture Reduction

“…If the plate is or becomes exposed, immediate coverage is critical. Titanium plate fixation may be considered if the plate is close to the incision site or if the patient has sinusitis or other source of infection [ 13 14 15 16 17 18 ].…”